Physical therapist Joanna Frantz provides physical therapy to Robert Banez, who recently had a knee replacement. She expects the Affordable Health Care Act to affect both her employees and her patients.

Joanna Frantz only has six employees at her clinic In Motion Physical Therapy off Jacksonville’s Hodges Boulevard, but she’s thinking about the Affordable Care Act and what insurance she will be required to purchase for those workers now that Barack Obama has been re-elected president.

“It is definitely something that concerns us,” she said.

Frantz is like many other small business owners on the First Coast about “Obamacare”: unsure, unaware or both. The Affordable Care Act, signed into law nearly three years ago, is headed for full implementation in January 2014, and business owners are scrambling to find out what it means.

Eileen Blocker, owner of Magnolia Properties Real Brokerage on Jacksonville’s Southside, acknowledged she’s anxious about the pending act. But as with so many other small business owners, she said the implications are overwhelming.

“It’s an ocean of unknowns,” said Blocker, who has four employees at her office and about 125 independent contractors. “I don’t think too many people have read it that I’m aware of. I think that’s still the case and that includes me.”

State and federal governments are set to establish, by next October, so-called “exchanges” that will serve as an information and coordination bank for affected small businesses.

Florida Gov. Rick Scott scored headlines last week when he backed off his strident opposition and said he’s willing to have a “conversation” with federal officials about establishing the exchanges through state resources. But that reinforced that the exchanges are largely undefined, adding to the uncertainty.

Janice Donaldson, regional director of the Small Business Development Center at the University of North Florida, said her office received about a dozen inquiries from small business owners the day after the election.

“We have had more calls since the day after the election than we have had in the past six months with questions about what it means,” Donaldson said. “Everything has been on hold for so long that small business owners have been in a wait-and-see attitude.”

The Jacksonville Business Exchange specializes in networking and commercial guidance for small- and medium-size businesses. Kevin Morris, the organization’s general manager, said the Affordable Care Act is now dominating much of the buzz in the small business community.

But Morris said the measure isn’t as ominous as some are perceiving it.

“It’s not what you know, it’s the approach you take to dealing with it,” Morris said. “They should look at what’s in it and what possible benefits are in it for them.”

One of those, for small businesses that aren’t even required to provide insurance under the act, is a simple competitive issue. Both Morris and Donaldson agreed that just because the law may not stipulate the smallest of businesses provide health insurance, the implications shouldn’t be ignored.

“By being able to offer a more competitive package, the same as what maybe a mid-sized company with 100 or 200 people can do, now they can compete for those same resources,” Morris said.

Part of the cost of not providing health care insurance is a penalty the government will assess.

Donaldson said several of the calls she received came from shop owners who asked if it would be advisable to just forgo providing insurance and pay penalties if it was less expensive. Donaldson and Morris both said they advise against choosing a penalty as an alternative.

UNF economist Paul Mason sees it differently.

First of all, Mason said, there are still details to the Affordable Care Act that are being developed. Most notably, the sanctions aspect of the program has not been defined and the dollar amounts of corresponding penalties aren’t final.

But when the penalty is defined, small businesses with 50 to 500 employees should consider the viability of paying penalties instead of providing insurance, even if that means alienating employees.

“There’s a major concern that particularly small business will stop providing health care,” Mason said. “The labor market is such that they’re not as concerned with being able to replace people who might leave because of it.”

The 35 percent deduction on taxes to offset some of the cost of implementing health care for the smallest of businesses may not be enough to convince those owners to provide it.

“If the law is written in such a way that you can circumvent it by paying the penalty and the penalty is cheaper than complying with the law, then that’s what you do,” Mason said.

He defended that possible scenario as ethical.

“If the law says that if you have more than 50 employees, you should provide health insurance, but here’s what you can do as an alternative and pay this penalty, then I don’t think that’s unethical if you decide to pay the penalty,” Mason said.

If a high number of businesses choose to pay the penalty initially, he said, the government will eventually hike the penalties.

While Frantz is wondering about the insurance she has to provide to her employees, she’s also trying to figure out what impact it will have on her physical therapy clinic. She deals with health insurance with virtually every patient.

“It will have a direct impact,” Frantz said. What that will be, though, she doesn’t know, nor can she tell if more people with insurance means more business.

“I don’t think I can tell you either way,” she said.

Ultimately, Mason said any business owner or corporate officer should start following as many updates as they can as the implementation of the Affordable Care Act approaches.

Donaldson provided literature from the Small Business Council of America that states the “health insurance exchanges” are on the way specifically for individuals and small businesses in January 2014.

Until then, updates on the act can be found at the council’s website, www.sbca.net.

"The Affordable Care Act does not require employers to provide health insurance for their employees.

"The Employer Responsibility provision of the Affordable Care Act applies [to] businesses with more than 50 full-time workers. To learn more read the Employer Bulletin on Automatic Enrollment, Employer Responsibility, and Waiting Periods."

Just a thought.. Has anyone at all researched it? I'm not a small business owner, but I think I sure as heck would have looked into it. As a voter, employee, and healthcare consumer, I looked at it to determine what, if any, impact it had on me.

Any critics of ACA out there know if any of these 2 small businesses, with less than 50 full-time employees, will be impacted? I say no.

What it very likely will do, is make their employees look to larger employers that will provide coverage for their employees, or pay a fine. When you hear or read "provide coverage", you do know that means that the business owner doesn't pay for all of it, right?